Coronavirus Severity and Repercussions
Here is a summary of the severity of coronavirus for the folks who still think it’s just a flu. It’s also for those who simply find it hard to keep track of the barrage of articles and posts coming in.
It references about 80 articles, largely from The New York Times.
Doctors’ Warnings
Here’s a video of a hospital in Italy. The doctor says “it’s not the flu; it’s very serious pneumonia” amidst footage of critical patients laying silently in oxygen hoods.
A U.S. surgeon who says “alarmist is not a word anyone has ever used to describe me before. […] Panic is not in my vocabulary; the emotion has been drilled out of me in nine years of training” concludes “The sky is falling.”
An Italian doctor in Bergamo says “The situation is now nothing short of dramatic. No other words come to mind. The war has literally exploded and battles are uninterrupted day and night.” She wrote this on March 11, when Italy had ~10,000 cases; as of today’s date, March 21, they now have 53,578. In the crisis, the doctor notes, “Each ventilator is like gold”.
33 year old Chinese doctor Li Wenliang, the first doctor to sound the alarm about the crisis in Wuhan, died of coronavirus about a month after his warning.
57 year old Italian doctor Marcello Natali appeared on TV to warn about the the crisis, and to say that his hospital had run out of gloves. He continued to work despite the shortage. Not long after, he tested positive and died. He had no preexisting conditions.
The front page of the New York Times Monday, March 20th, blared “Doctors Sound Alarm As Nation Struggles.”
The chief of critical care at Long Island Jewish Medical Center says that “patients walk into the hospital, talking, or into urgent care. And 12 hours later, they’re on a ventilator, fighting for their life.” She says “we don’t see that course in progression like this with any other disease we deal with.” She also says that covid patients stay in the ICU for much longer (2 weeks) than a typical patient (3–4 days), which further throttles the healthcare system.
An American doctor grippingly details his experience of the first 3 days of coronavirus in the ICU, and days 4–7.
Shortages
The United States does not have enough ventilators to cope with coronavirus, and confirmed coronavirus cases are growing faster there than any other country in the world. It is now on track to surpass the situations in China and Italy.
Britain also has a serious shortage of ventilators. (Though the U.K. is now returning to its wartime solution of reaching out to aerospace and engineering companies like Rolls Royce to produce the equipment.)
A scientist in Canada’s most populated province, Ontario, says that if they cannot keep their distancing preventions in place, their hospital will likely run out of capacity in the next 2 weeks.
Obviously, these conditions can shift, and multiple governments, philanthropists and businesses are actively working to improve them by securing or building additional hospitals, masks and equipment.
But as it is currently, the shortage is very alarming. It is extremely concerning for the predominantly elderly and immunocompromised lives at risk. (And Americans should feel uneasy when they find out that diabetes and obesity are considered underlying conditions.)
The trend seems to be that hospitals over the U.S. and Italy are being converted to wartime continuous coronavirus triage centers.
If the situation gets worse, healthcare workers may soon need to choose whom to save, as doctors have already been forced to do in parts of Italy.
This compression of healthcare forces mean that when people inevitably need to go to the hospital for other traumas over the coming months, like car crashes, strokes, or heart attacks, they may not be able to get treatment.
U.S. testing has also been incredibly low. The New York Times shares the following graphic from the CDC, comparing U.S. testing to Italy’s and South Korea’s.
Canada has been better about testing, but still lags behind South Korea, which has been one of the few countries that have been successful in containing the virus.
The problem with such dismal testing is that the U.S. and others of its ilk are flying blind. As the World Health Organization’s director general says about the virus, “you cannot fight a fire blindfolded.”
The low rate of testing endangers doctors and healthcare workers, who are already risking their lives to save patients every day. They cannot be certain which patients have it — or even if they themselves have it, thus spreading it to their patients— until they are allowed adequate testing.
The shortage of gloves and masks for healthcare workers puts them in still greater jeopardy. Some American hospital workers have resorted to wearing home-made face shields and goggles. President Trump has gone back and forth on invoking the Defense Protection Act to mobilize war-scale manufacturing for critical items, and federal health officials have announced plans to buy more masks.
It is unclear, however, how long it will take this equipment to get to the hospital frontlines.
Another emergency room doctor in the U.S. describes their protective routine as “literally, wash your hands a lot, cross your fingers, and pray”.
In Italy, 61 doctors have died on the virus frontlines. More than 2,600 healthcare workers have been infected.
In China, more than 3,000 doctors were infected.
Nearly 14% of Spain’s confirmed cases are medical professionals.
A phD ran the numbers and projected that U.S. hospital beds will run out between May 2–May 14.
It is sobering to consider how these numbers may grow throughout the health crisis — both in terms of the human lives lost, and how critically ill patients may need to go to hospitals that do not have enough doctors, personnel or equipment to treat them.
Coronavirus is modifying the supply chain as well. Amazon is stopping shipment of non-essentials for the next 3 weeks so they can prioritize food and household essentials like toilet paper.
More encouragingly, other U.K. firms are stepping in to produce thousands more ventilators for the NHS. One firm is projecting that it can build 1,000 per day.
Richard Branson’s rocket company Virgin Orbit is going to begin mass producing ventilators.
Europe
Italy’s rate of new coronavirus cases is finally beginning to drop, but their situation is still serious. They are at a total of 80,539 confirmed cases in the country. As of March 26, they have 8,165 dead. Chinese specialists have said their current restrictions are “not strict enough”, and the military will now be used to enforce the lockdown.
A Harvard epidemiologist mocked the U.K.’s initial plan of herd immunity. “When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire.” “This is not a flu pandemic,” he says. “Flu rules do not apply.”
Prime Minister Boris Johnson backtracked from his original herd immunity plan, and has now closed all restaurants, gyms and pubs for the foreseeable future.
London hospitals are already struggling to cope with coronavirus surge.
The U.K. is begging 65,000 former doctors and nurses to come back to fight the virus.
Grimly, on March 20, Spain became the second European country to report over 1,000 deaths. Italy had 1,000 deaths a week ago; doctors warn that their health system may soon become overwhelmed, just as Italy’s did.
Madrid has turned an ice skating rink into a morgue to deal with the overflow of dead.
U.S.
The severity of the situation is becoming starkly apparent across the country.
Coronavirus cases already top 300,000 in the country. Here is the New York Times’ interactive map showing the spread of coronavirus across the U.S.
As of March 26, the U.S.’s death toll has passed 1,000.
As of March 30 in New York, the governor has said that 1,218 people have died and 9,517 people were hospitalized.
In New York, video shows medical staff using a forklift to load bodies into trucks acting as makeshift morgues in Brooklyn. An emergency hospital is being constructed in Central Park.
New York City is projected to run out of medical supplies within two to three weeks.
The U.S. has 924,107 staffed beds in hospitals, total.
One study suggests that nearly 2 million Americans could require care in an ICU. Millions of older Americans live in counties with no ICU beds at all.
An emergency physician from Mass General/Harvard Medical School is asking all non-healthcare workers to please self-quarantine. He linked to this prediction breakdown of American deaths, which suggests that, if unchecked, close to 4 million Americans would die in 3 months.
U.S. hospitals are limiting or canceling elective surgeries, and letting doctors practice across state lines.
The crisis is likely to result in layoffs on a scale the U.S. has never seen before. “Upcoming weekly jobless claims will shatter the standards set even during the worst points of the financial crisis and the early-1980s recession, with Bank of America forecasting a total of 3 million when the number is released Thursday. Those figures are expected to be so bad, in fact, that the Trump administration, according to several media reports, has asked state officials to delay releasing precise counts.”
Major metropolitans Los Angeles, San Francisco, and New York City are on stay-at-home orders. Governor Newsom has deployed the California National Guard to assist food banks during the coronavirus outbreak.
There are efforts to combat the severity. 1,000 retired and private practice doctors and nurses answer the call and join the effort so far. The military is also working to convert buildings into hospitals that could potentially provide an additional 10,000 hospital beds. They hope to complete this in 3 or 4 weeks.
A 15 minute antibody test has been cleared for use by the FDA.
Asia
China, which has had 81,008 cases, appears to now have a handle on the crisis. After more than 40 days of lockdown, it has had zero local cases for the third day (though imported infections rise).
Wuhan is still reeling from the tragedy. A person who has chosen to be anonymous writes “My family and I are living in Hell. [….] When someone says we can accomplish something, but we must pay a price, do not rush to applaud. One day you may become the price that is paid.”
China sent 1 million respirators to the Czech Republic, and 300 Chinese doctors to Italy.
Chinese billionaire Jack Ma donated 1 million face masks and 500,000 test kits to the U.S., and says he will donate 1.1 million testing kits, 6 million masks, and 60,000 protective suits and face shields to all countries in Africa.
Due to a combination of aggressive testing and retroactively contact-tracing anyone infected, South Korea has been one of the few countries that have kept their coronavirus cases in check. As of March 17, they reported only 74 new cases for the day.
Despite being one of the first countries outside of China to get cases, Japan has appeared remarkably immune so far, which is “puzzling health experts”. But as of March 26, Japan’s health minister has informed Prime Minister Shinzo Abe that Japan is now at a high risk for rampant infection.
Additional Notes on Age
Coronavirus is significantly more dangerous in older patients. 80% of deaths are adults over the age of 65. The average age of licensed physicians in the U.S. is 51.5 years old as of 2019, which puts a significant portion of physicians in the higher risk age bracket.
In rural hospitals, the hospitals “are very lean, and a lot of the physicians are older, meaning they have their own coronavirus risks.”
Younger people are not immune to serious illness, either. “38% of patients who have been hospitalized are between the ages of 20 and 54”. This is a big range, and would be more helpful if it were split along smaller groups; but it puts lie to the idea that this is solely an old people’s problem.
Several younger doctors — 33 year old Dr. Li Wenliang (the first doctor to sound the alarm about the crisis in Wuhan), 29 year old Dr. Xia Sisi, and 29 year old Dr. Peng Yinhua — have already died.
There is conflicting evidence about whether a high viral load (such as what doctors, pharmacists, and emergency technicians would be exposed to) correlates with more severe cases. Initial viral load does dictate the severity for the common cold.
Repercussions, Current and Future
The bulk of our worry and efforts have to go toward the lives on the line. That is plain.
But questions also arise about the fallout. How will this turbulence affect politics, the healthcare system, the already-tanking global economy, and education?
In the vacuum of power, China is already “positioning itself as the global leader in the pandemic response”. As its crisis has dwindled, it has turned its focus outward to send aid to the world. Claremont College professor Minxin Pei writes, “Donating medical supplies shows China is a responsible and generous world power. It is also touting its success in containing the coronavirus outbreak to suggest its one-party regime is superior to the bumbling democracies in the West, in particular in the U.S.”
In the U.S., the outlook looks bleak. Coronavirus will cause an unprecedented strain on an already-broken healthcare system. The U.S. also faces massive impending unemployment, with a projected 500,000 to as high as 5 million job losses in April.
In Italy and China, men were more likely to die than women. ‘“Being male is as much a risk factor as being old,” says Sabra Klein, a scientist who studies sex difference in viral infections at John Hopkins Bloomberg School of Public Health. Some 8% of male patients died, compared to 5% of female patients, according to a Higher Health Institute of Rome analysis of 25,058 cases.’
Of Forbes’ 75 Most Powerful People list in 2020, 93% were male, and 7% were female. Of the men, 34 were 65 years or older, putting them in the high risk group for coronavirus. Of course, their money may be enough to cushion them. But if not, what will be the repercussions?
Similarly, it is also worth noting that according to Bloomberg, the average age of a CEO is 58 years old, while the average age of a U.S. millionaire is 62 years old. Congress skews older as well: according to the Congressional Research Service, the average age of members of the House is 57.8, and the average age of Senators is 61.8. Donald Trump is 73, and presumptive Democrat nominee Joe Biden is 77 years old.
Billionaires Michael Bloomberg, Bill Gates and Jack Ma are 78, 64, and 55 respectively.
Of the older Supreme Court justices, Ruth Bader Ginsburg is 87, Stephen Breyer is 81, Clarence Thomas is 71, Samuel Alito is 69, Sonia Sotomayor is 65, and Elena Kagan is 59.
Across different sectors, these individuals are effectively running the world.
There is the potential for considerable business, economic and political upset if these leaders get severely sick or die.
Despite the widespread tragedy, there is some environmental silver lining.
As huge populations are staying at home instead of driving, there are significant effects on the environment. Scientists say that “by May, when CO2 emissions are at their peak, the levels recorded might be the lowest since the financial crisis over a decade ago.” Columbia University researchers told the BBC that their early results showed that carbon monoxide, mainly from cars, had been reduced by nearly 50% compared to last year.
As we temporarily scramble toward mass teleworking, telehealth and online education, will we see an ongoing shift toward them as the new normal — partly influenced by their much-needed positive effects on the environment?
As the old Chinese curse goes, “May you live in interesting times.”
Summary
Panic isn’t helpful. But without drastic measures, this humanitarian disaster is poised to get exponentially worse. It is incredibly important to self-quarantine and take this seriously.
Stay at home.
